Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Am J Otolaryngol. 2022 Sep-Oct;43(5):103528. doi: 10.1016/j.amjoto.2022.103528. Epub 2022 Jun 5.
Idiopathic sudden sensorineural hearing loss (ISSNHL) presents with emergent hearing impairment and is mainly treated with steroids. However, limited data exist regarding the prognostic factors among elderly patients (>65 years old) who receive an intra-tympanic steroid injection (ITSI). Therefore, we investigated the prognostic factors in these patients.
Between July 2016 and March 2022, we retrospectively enrolled 105 elderly patients (>65 years old) with unilateral ISSNHL who were treated with an ITSI, and recorded their clinical and audiological variables.
The patients had a mean age of 72.03 ± 6.33 years and mean hearing level gain of 22.86 ± 21.84 dB, speech reception threshold (SRT) gain of 15.77 ± 35.27 dB, and speech discrimination score (SDS) gain of 19.54 ± 27.81 %. According to Siegel's criteria, 5 (4.76 %), 44 (41.91 %), 46 (43.81 %), and 10 (9.52 %) patients had complete recovery, partial recovery, slight improvement, and no improvement, respectively. In the univariate analysis, vertigo (odds ratio [OR] = 0.290, 95 % confidence interval [CI]: 0.130-0.651, p = 0.002) and profound hearing loss on pure tone audiometry (PTA; OR = 0.233, 95 % CI: 0.101-0.536, p = 0.004) were negative prognostic factors among elderly ISSNHL patients. In the multivariate analysis, vertigo (OR = 0.300, 95 % CI: 0.128-0.705, p = 0.005) and profound pure tone audiometry (OR = 0.240, 95 % CI: 0.101-0.570, p = 0.001) were independent adverse prognostic factors among elderly ISSNHL patients.
We demonstrated the treatment outcomes of 105 elderly ISSNHL patients after an ITSI. Vertigo and profound PTA are independent adverse risk factors among elderly ISSNHL patients, and patients with these risk factors require active treatment.
特发性突发性聋（ISSNHL）表现为突发性听力损失，主要采用类固醇治疗。然而，对于接受鼓室内类固醇注射（ITSI）治疗的老年患者（>65 岁），其预后因素的数据有限。因此，我们对这些患者的预后因素进行了研究。
我们回顾性纳入了 2016 年 7 月至 2022 年 3 月间 105 例接受 ITSI 治疗的单侧 ISSNHL 老年患者，并记录了他们的临床和听力变量。
患者的平均年龄为 72.03±6.33 岁，平均听力水平提高 22.86±21.84dB，言语接受阈（SRT）提高 15.77±35.27dB，言语辨别率（SDS）提高 19.54±27.81%。根据 Siegel 的标准，5（4.76%）例、44（41.91%）例、46（43.81%）例和 10（9.52%）例患者完全恢复、部分恢复、略有改善和无改善。在单因素分析中，眩晕（比值比[OR] = 0.290，95%置信区间[CI]：0.130-0.651，p = 0.002）和纯音测听（PTA）重度听力损失（OR = 0.233，95%CI：0.101-0.536，p = 0.004）是老年 ISSNHL 患者的负面预后因素。在多因素分析中，眩晕（OR = 0.300，95%CI：0.128-0.705，p = 0.005）和重度 PTA（OR = 0.240，95%CI：0.101-0.570，p = 0.001）是老年 ISSNHL 患者的独立不良预后因素。
我们展示了 105 例接受 ITSI 治疗的老年 ISSNHL 患者的治疗结果。眩晕和 PTA 重度是老年 ISSNHL 患者的独立不良风险因素，这些患者需要积极治疗。
